Page 343 - Saunders Comprehensive Review For NCLEX-RN

than processed foods that contain
higher amounts of sodium.
c. Canned, frozen, instant, smoked,
pickled, and boxed foods usually
contain higher amounts of sodium.
Lunch meats, soy sauce, salad
dressings, fast foods, soups, and
snacks such as potato chips and
pretzels also contain large amounts of
sodium; teach clients to read
nutritional facts on product packaging
regarding sodium content per serving.
d. Certain medications contain significant
amounts of sodium.
e. Salt substitutes may be used to improve
palatability; most salt substitutes
contain large amounts of potassium
and should not be used by clients with
renal disease.
L. Protein-restricted diet
1. Indication: Used for renal disease and end-stage liver
disease.
2. The nutritional status of critically ill clients with
protein-losing renal diseases, malabsorption
syndromes, and continuous renal replacement
therapy or dialysis should have their protein needs
assessed by estimating the protein equivalent of
nitrogen appearance (PNA); a nutritionist should be
consulted.
3. Nursing considerations
a. Provide enough protein to maintain
nutritional status but not an amount
that will allow the buildup of waste
products from protein metabolism (40
to 60 g of protein daily).
b. The less protein allowed, the more
important it becomes that all protein in
the diet be of high biological value
(contain all essential amino acids in
recommended proportions).
c. An adequate total energy intake from
foods is critical for clients on protein-
restricted diets (protein will be used
for energy rather than for protein
synthesis).
d. Special low-protein products, such as
pastas, bread, cookies, wafers, and
gelatin made with wheat starch, can

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